EP0858295B1 - Instrument electrochirurgical - Google Patents

Instrument electrochirurgical Download PDF

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Publication number
EP0858295B1
EP0858295B1 EP96935052A EP96935052A EP0858295B1 EP 0858295 B1 EP0858295 B1 EP 0858295B1 EP 96935052 A EP96935052 A EP 96935052A EP 96935052 A EP96935052 A EP 96935052A EP 0858295 B1 EP0858295 B1 EP 0858295B1
Authority
EP
European Patent Office
Prior art keywords
generator
handpiece
shield
instrument according
frequency
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP96935052A
Other languages
German (de)
English (en)
Other versions
EP0858295A1 (fr
Inventor
Colin Charles Owen Goble
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Gyrus Medical Ltd
Original Assignee
Gyrus Medical Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Gyrus Medical Ltd filed Critical Gyrus Medical Ltd
Publication of EP0858295A1 publication Critical patent/EP0858295A1/fr
Application granted granted Critical
Publication of EP0858295B1 publication Critical patent/EP0858295B1/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1402Probes for open surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/0066Sensing and controlling the application of energy without feedback, i.e. open loop control
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1226Generators therefor powered by a battery

Definitions

  • This invention relates to an electrosurgical instrument having a monopolar electrode unit, and in particular to an instrument which is operable at high frequencies, typically in excess of 5 MHz.
  • a known electrosurgical system comprises a handpiece, a monopolar electrode unit having a single treatment electrode projecting from the handpiece, a generator unit, and a cable coupling the generator unit to the handpiece.
  • Such systems are commonly used for various types of electrosurgery.
  • a conductive pad is applied to the body of the patient and connected to a return terminal of the generator unit to provide a return path for electrosurgical currents.
  • Disadvantages of this arrangement include the localisation of electrosurgical currents in tissue in the region of the return pad and, particularly at higher frequencies, the unpredictability of reactive components created by the cable between the generator and the handpiece, leading to unpredictable voltage levels at the electrode.
  • an electrosurgical instrument comprising a handpiece, a monopolar electrode unit having a single treatment electrode projecting from the handpiece, and a radio-frequency generator within the handpiece, the handpiece including an electrically conductive shield around the generator as a capacitive coupling element between the generator and the surroundings, and wherein the generator has no radio-frequency connections other than a single radio-frequency output connection to the treatment electrode for providing an active output connection between generator and the patient, and, in use, a return path between the generator and the patient provided by said capacitive coupling.
  • the generator allows the generator to be isolated from external elements other than the electrode.
  • the generator has no other radio frequency output connection to, for example, an earthed element or to a return pad.
  • Radio-frequency return currents pass between the patient and the generator by stray capacitive coupling via a conductive shield located around the generator.
  • the operating frequency of the generator is 5 MHz or greater.
  • the generator may be powered from a battery within the handpiece. This minimises radiated interface.
  • the presence of an electrically conductive shield around the generator minimises the variation in stray capacitance caused by the user gripping the handpiece in different ways.
  • the shield is preferably isolated from the generator and may form a tubular handpiece body, e.g. in the form of a metallic casing, or the handpiece body may be formed of an electrically insulative material which is metallised to provide the conductive shield. Where the metallisation layer is on the outside of the handpiece body, or the handpiece body is itself metallic, the outer metallic surface is preferably covered by an electrically insulating outer layer. Provision of the shield reduces stray capacitance variations because the capacitance between the relevant generator conductors and the shield is constant. and the shield provides a conductive body of constant area capacitively coupled to the patient.
  • an instrument in accordance with the invention comprises an elongate cylindrical handpiece 10 which may be held "pencil-fashion" as shown.
  • One end portion 10A of the handpiece is tapered and an electrode unit in the form of a single treatment electrode 12 projects axially from that end so that it may be brought into contact with the body 14 of a patient.
  • An activating switch 16 is provided on the tapered end portion 10A.
  • the body 10 of the handpiece may be formed from sheet metal, and provided with an insulating covering made from, for instance, a film material.
  • the handpiece body 10 may be moulded from an electrically insulative plastics material, and metallised either on the inner or the outer surface. If the metallisation is on the outer surface. an electrically insulating coating is provided to isolate the metallisation from the user's hand.
  • the handpiece body 10 is shown as comprising the conductive shield 10S and an insulation case 10C.
  • An internal electronic unit 18 comprising a radio frequency generator and a battery is contained within the shield 10S. Although it is not essential for the electronic unit 18 to be completely encased by the shield 10S as shown, it is preferable that at least the generator part lies with the lengthwise extent of the shield.
  • the shield 10S has a number of useful properties.
  • the internal electronic unit 18 has a non-uniform mass and distribution within the case, with different potentials relative to earth.
  • the shield 10S provides a uniform surface of the same or uniform potential.
  • the internal electronics are also effectively screened against the potentially interfering levels of RF radiation.
  • Making the case out of metal to provide the shield function also has an added advantage in that the shield provides uniform heat distribution and therefore improves the dissipation of power generated within the electronic unit due to inefficiencies.
  • a radio frequency (RF) generator 18G operable at a frequency of 5 MHz or higher (switch 16 and shield 10S are not shown in Figure 3).
  • the generator has an output connection coupled to the electrode 12 ( Figure 1), and has no other output connection.
  • Conductive elements of the generator 18G act as an antenna 22 and are capacitively coupled. indirectly via the conductive shield 10S of the handpiece body 10 (see Figures 1 and 2) via capacitance 24 to the patient 14, represented as a second antenna in Figure 3.
  • the electrode to tissue interface is represented by line 26.
  • the active output connection of the generator 18 is connected to the patient 14 through the tissue being operated on.
  • the resistance of this tissue being represented by resistance 28 in Figure 3.
  • the value of this resistance is typically 1 k ⁇ , and can drop to as low as 100 ⁇ .
  • the radiating conductors 20 of the generator 18G are also capacitively connected to the user by capacitance 30, which is the series combination of the generator-to-shield and shield-to-user capacitances.
  • the user 32 being, in turn capacitively coupled to ground as represented by capacitor 34.
  • the patient 14 is also capacitively coupled to ground (as represented by capacitor 36 in Figure 3), there exists an indirect as well as a direct capacitive path between the user 32 and the patient 14.
  • the total capacitance between the generator 18G and the patient 14 resulting from the direct generator-to-patient capacitance 24, handpiece-body-to-user capacitance 30, user-to-ground, handpiece body-to-ground, and patient-to-ground capacitances 34, 38 and 36 respectively, is at least 15 pF.
  • a battery which is also housed within the handpiece body 10. This is preferably a nickel-cadmium or lithium-ion battery, rechargeable via terminals in the opposite end of the body 10 from the electrode 12.
  • This instrument is primarily, but not exclusively, intended for fine surgical work, such as spinal, neurological, plastic, ear-nose-and-throat and dental surgery, and office procedures.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Otolaryngology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Materials For Medical Uses (AREA)

Claims (9)

  1. Instrument électrochirurgical comprenant un embout à main (10), un module d'électrode monopolaire comportant une électrode de traitement unique (12) se projetant depuis l'embout à main et un générateur de fréquences radio (18G) situé dans l'embout à main, l'embout à main, comportant un blindage électriquement conducteur (10S) autour du générateur comme élément de couplage capacitif entre le générateur et l'environnement et dans lequel le générateur ne comporte aucune connexion à fréquences radio autres qu'une simple connexion de sortie à fréquences radio avec l'électrode de traitement pour fournir une connexion de sortie active entre le générateur et le patient et, pendant l'utilisation, un chemin de retour entre le générateur et le patient, constitué par ledit couplage capacitif.
  2. Instrument selon la revendication 1, dans lequel la fréquence de fonctionnement du générateur est de 5 MHz ou supérieure.
  3. Instrument selon la revendication 1 ou la revendication 2, dans lequel le générateur est alimenté par une batterie située dans l'embout à main (10).
  4. Instrument selon la revendication 1, dans lequel le blindage (10S) est isolé du générateur (18G).
  5. Instrument selon l'une quelconque des revendications 1 à 4, dans lequel le blindage (10S) constitue le corps de l'embout à main.
  6. Instrument selon la revendication 5, dans lequel le corps de l'embout à main est un tube métallique avec un film isolant (10C) appliqué sur sa surface externe.
  7. Instrument selon l'une quelconque des revendications 1 à 4, dans lequel le blindage (10S) est généralement tubulaire et le générateur (18G) est contenu à l'intérieur de la longueur du blindage.
  8. Instrument selon l'une quelconque des revendications 1 à 4, dans lequel l'embout à main (10) comporte un corps d'embout à main formé d'un matériau électriquement isolant et le blindage est une couche de métallisation sur le corps de l'embout à main.
  9. Instrument selon la revendication 8, dans lequel la couche de métallisation se trouve sur l'extérieur du corps de l'embout à main et est recouverte d'une couche externe électriquement isolante.
EP96935052A 1995-10-24 1996-10-21 Instrument electrochirurgical Expired - Lifetime EP0858295B1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
GB9521772 1995-10-24
GBGB9521772.5A GB9521772D0 (en) 1995-10-24 1995-10-24 An electrosurgical instrument
PCT/GB1996/002577 WO1997015237A1 (fr) 1995-10-24 1996-10-21 Instrument electrochirurgical a main fonctionnant sur accumulateurs electriques

Publications (2)

Publication Number Publication Date
EP0858295A1 EP0858295A1 (fr) 1998-08-19
EP0858295B1 true EP0858295B1 (fr) 2002-12-18

Family

ID=10782829

Family Applications (1)

Application Number Title Priority Date Filing Date
EP96935052A Expired - Lifetime EP0858295B1 (fr) 1995-10-24 1996-10-21 Instrument electrochirurgical

Country Status (10)

Country Link
US (1) US6039734A (fr)
EP (1) EP0858295B1 (fr)
JP (1) JP2001507247A (fr)
KR (1) KR19990067035A (fr)
AU (1) AU721066B2 (fr)
BR (1) BR9611197A (fr)
CA (1) CA2235488A1 (fr)
DE (1) DE69625502T2 (fr)
GB (1) GB9521772D0 (fr)
WO (1) WO1997015237A1 (fr)

Cited By (243)

* Cited by examiner, † Cited by third party
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US7736361B2 (en) 2003-02-14 2010-06-15 The Board Of Trustees Of The Leland Stamford Junior University Electrosurgical system with uniformly enhanced electric field and minimal collateral damage
US7789879B2 (en) 2002-05-03 2010-09-07 Board Of Trustees Of The Leland Stanford Junior University System for plasma-mediated thermo-electrical surgery
US8043286B2 (en) 2002-05-03 2011-10-25 The Board Of Trustees Of The Leland Stanford Junior University Method and apparatus for plasma-mediated thermo-electrical ablation
US8066167B2 (en) 2009-03-23 2011-11-29 Ethicon Endo-Surgery, Inc. Circular surgical stapling instrument with anvil locking system
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US8083120B2 (en) 2008-09-18 2011-12-27 Ethicon Endo-Surgery, Inc. End effector for use with a surgical cutting and stapling instrument
US8113410B2 (en) 2008-02-14 2012-02-14 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features
US8136712B2 (en) 2009-12-10 2012-03-20 Ethicon Endo-Surgery, Inc. Surgical stapler with discrete staple height adjustment and tactile feedback
US8141762B2 (en) 2009-10-09 2012-03-27 Ethicon Endo-Surgery, Inc. Surgical stapler comprising a staple pocket
US8157153B2 (en) 2006-01-31 2012-04-17 Ethicon Endo-Surgery, Inc. Surgical instrument with force-feedback capabilities
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US8161977B2 (en) 2006-01-31 2012-04-24 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US8177783B2 (en) 2006-11-02 2012-05-15 Peak Surgical, Inc. Electric plasma-mediated cutting and coagulation of tissue and surgical apparatus
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US8186560B2 (en) 2007-03-15 2012-05-29 Ethicon Endo-Surgery, Inc. Surgical stapling systems and staple cartridges for deploying surgical staples with tissue compression features
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BR9611197A (pt) 1999-04-06
CA2235488A1 (fr) 1997-05-01
EP0858295A1 (fr) 1998-08-19
AU721066B2 (en) 2000-06-22
KR19990067035A (ko) 1999-08-16
WO1997015237A1 (fr) 1997-05-01
AU7315296A (en) 1997-05-15
JP2001507247A (ja) 2001-06-05
DE69625502D1 (de) 2003-01-30
MX9803194A (es) 1998-09-30
US6039734A (en) 2000-03-21
DE69625502T2 (de) 2003-09-11
GB9521772D0 (en) 1996-01-03

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